Preservation of short-term energy balance in clinically stable patients with AIDS

Article Abstract:

Malnutrition and severe weight loss (wasting) are common complications of AIDS, the acquired immune deficiency syndrome. Malnutrition may be one of the earliest symptoms of the disease and may worsen as AIDS progresses, or it may follow an alternating pattern of nutritional stability and wasting. Some of the causes of weight loss are reduced food intake, diarrhea, and elevated metabolic rate due to fever or opportunistic infections. While malnutrition is often a persistent problem in AIDS patients, some cases of successful weight gain after treatment for AIDS complications have been reported. Most studies of nutrition during the disease have focused on patients who were experiencing serious complications; no nutrition surveys have been done on patients who are free of active complications. A study of energy balance in five clinically stable AIDS patients was conducted; these patients were compared with six homosexual and five heterosexual control subjects who were not infected with HIV (human immunodeficiency virus). The five AIDS patients maintained stable body cell mass throughout the six-week study and had normal caloric intake. At the start of the study, they were undernourished, a condition which was apparently due to chronic malabsorption of nutrients. Intestinal malabsorption in AIDS generally results from immune deficiency, as the intestines are vulnerable to damage from many infections. The AIDS patients exhibited a lower metabolic rate as an appropriate way of adapting to their nutrient malabsorption. In conclusion, the energy metabolism of AIDS patients varies according to the presence of complications; during clinical stability nutrition can be maintained. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, HIV (Viruses), HIV, Energy metabolism

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Magnitude of body-cell-mass depletion and the timing of death from wasting in AIDS

Article Abstract:

Patients with acquired immunodeficiency syndrome (AIDS) typically experience weight loss, which may be severe and progressive. AIDS patients become malnourished for several reasons including poor appetite and infections in the mouth that interfere with eating. The effect of malnutrition on the timing of death in AIDS patients was investigated. Body cell mass (total bulk of the body) was measured as an indicator of malnutrition for 32 patients within 100 days of their death. The technique for estimating body cell mass was to count body cells with a whole-body liquid scintillation counter; this machine measures the natural radioactive emission from the potassium found in all body cells. As patients neared death, their body cell mass became progressively smaller. At the time of death, average body cell mass was only 54 percent of normal. Body weight had a parallel relationship to time of death, with the projected weight at death being 66 percent of ideal weight for height and sex. The authors conclude that death occurred when body cell mass reached a critically low level below which patients could not survive. Body cell mass appeared to influence timing of death independent of the AIDS-related illnesses, such as pneumonia, that were present. A minimum body cell mass may be required for the individual to perform necessary functions, such as coughing to clear lung secretions. The results imply that efforts to maintain body cell mass by improving nutrition could prolong life for AIDS patients. Other chronic, debilitating diseases may involve a similar relationship between body cell mass and time of death.

Patient outcomes, Mortality, Food and nutrition, AIDS patients, Body weight, Potassium in the body, Potassium (Nutrient)

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Body composition in elderly subjects: a critical appraisal of clinical methodology

Article Abstract:

Body composition refers to the proportions of different types of body tissues, such as fat, muscle, bone, and body fluids. Evaluation of body composition reveals important information about the health and nutrition of the individual. The elderly population is growing, and techniques for assessing body composition in this group are needed; methods of measurement that are accurate for younger adults may not be reliable in older individuals. Techniques already accepted for use in the general adult population were tested with elderly subjects and adjusted for application in this population. For older individuals, the newest techniques appear most promising; these include dual photon absorptiometry and neutron activation analysis, which are radiologic methods for quantifying bone mineral. With the help of these approaches, a large number of healthy elderly persons can be assessed whereas previous approaches were limited to a small number of cadavers. While traditional assessments view the body as containing two compartments, fat and fat-free tissue, a more sophisticated approach is recommended. Body composition can better be characterized as containing five compartments, which are fat, bone mineral, body cell mass, total body water, and extracellular fluid.

Aging, Analysis, Measurement, Physiological aspects, Obesity, Body composition, Leanness

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